Financial Clearance Specialist

Job not on LinkedIn

🔥 56 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

💸 Financial Planning and Analysis (FP&A)

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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Logo of Solaris Health

Solaris Health

1001 - 5000 employees

Founded 2020

⚕️ Healthcare Insurance

🏥 Healthcare

🧬 Biotechnology

Healthcare Insurance • Healthcare • Biotechnology

Solaris Health is a leading national healthcare platform committed to enhancing access to specialty healthcare and continually improving patient outcomes. With over 1 million unique patients annually and 730+ providers across the country, Solaris Health operates 236+ patient offices in 14 states, focusing on innovative delivery of high-quality, value-driven care.

📋 Description

• Verify insurance coverage and benefit information using payer portals, clearinghouses, and direct communication with insurers • Confirm plan status, effective dates, co-pays, deductibles, coinsurance, and authorization requirements • Accurately document verification results in the EHR and/or PM • Submit prior authorization requests for services, tests, and procedures based on payer requirements • Monitor and follow up on pending authorizations to avoid delays in patient care • Address denied or delayed authorizations with payers and escalate unresolved issues to the Supervisor as needed • Coordinate with clinical staff to gather and submit necessary documentation for authorization approval • Notify appropriate teams of coverage issues, authorization status, or patient financial risk • Communicate with patients regarding insurance coverage, financial responsibilities, and authorization outcomes when appropriate • Collaborate with schedulers and front-desk teams to ensure appointments align with insurance requirements • Follow standardized workflows and documentation protocols outlined by the Supervisor • Maintain accuracy and timeliness in financial clearance documentation • Participate in daily team huddles and contribute to process improvement initiatives • Perform other position-related duties as assigned • Work closely with scheduling, clinical, and billing teams under the guidance of the Manager/Supervisor of Financial Clearance • Adhere to ethical conduct standards and assist with compliance requirements

🎯 Requirements

• High School Diploma or equivalent required • 1–3 years of experience in insurance verification, medical authorizations, or revenue cycle operations • Knowledge of commercial, Medicare, Medicaid, and managed care insurance plans • Strong attention to detail and organizational skills • Proficiency in EHR systems, payer portals, and Microsoft Office • Excellent communication and problem-solving abilities • Professional verbal and written communication skills • Knowledge of medical terminology, healthcare coding systems, and clinics functions • Must comply with applicable laws and regulations, Solaris Health Code of Conduct, and company policies and procedures • Must maintain confidentiality of patients' protected health information in compliance with HIPAA • Must complete Annual Compliance Training • Associate’s degree in healthcare, business, or related field preferred

🏖️ Benefits

• Competitive pay • PTO • Holiday pay • Comprehensive benefits package • Health insurance • Dental insurance • Vision insurance • Life Insurance • Pet Insurance • Health savings account • Paid sick time • Paid time off • Paid holidays • Profit sharing • Retirement plan

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